Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $74.13 / $512.86	Facility		$52.48	$74.13	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $61.66 / $100.00	Professional		$25.12	$61.66	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $75.86 / $194.98	Professional		$28.84	$75.86	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $112.20 / $407.38	Professional		$26.30	$112.20	$407.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $75.86 / $131.83	Facility		$26.92	$75.86	$131.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $131.83 / $467.74	Professional		$70.79	$131.83	$467.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $112.20 / $208.93	Professional		$40.74	$112.20	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $100.00 / $208.93	Professional		$66.07	$100.00	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $100.00 / $120.23	Facility		$43.65	$100.00	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $70.79 / $165.96	Professional		$29.51	$70.79	$165.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $58.88 / $186.21	Professional		$48.98	$58.88	$186.21